2023-09-28 14:46:10 +00:00
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abstract: 'Introduction The burden of childhood mortality continues to be born
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largely by low-income and middle-income countries. The critical
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postdischarge period has been largely neglected despite evidence that
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mortality rates during this period can exceed inpatient mortality rates.
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However, there is a paucity of data on the paediatric discharge process
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from the perspective of the healthcare provider. Provider perspectives
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may be important in the development of an improved understanding of the
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barriers and facilitators to improving the transition from hospital to
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home.
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Objectives To explore healthcare providers'' and facility administrators''
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perspectives of the paediatric discharge process with respect to: (1)
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current procedures, (2) barriers and challenges, (3) ideas for change,
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(4) facilitators for change and (5) the importance of discharge
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planning.
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Design A qualitative exploratory approach using focus groups (14) and
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in-depth interviews (7).
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Setting This study was conducted at seven hospitals providing paediatric
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care in Uganda.
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Results Current discharge procedures are largely based on
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hospital-specific protocols or clinician opinion, as opposed to national
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guidelines. Some key barriers to an improved discharge process included
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caregiver resources and education, critical communication gaps,
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traditional practices, and a lack of human and physical resources.
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Teamwork and motivation to see improved paediatric transitions to home
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were identified as facilitators to implementing the ideas for change
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proposed by participants. The need for a standardised national policy
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guiding paediatric discharges, implemented through education at many
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levels and coupled with appropriate community referral and follow-up,
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was broadly perceived as essential to improving outcomes for children.
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Conclusions Although significant challenges and gaps were identified
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within the current health system, participants'' ideas and the identified
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facilitators provide a significant basis from which change may occur.
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This work can facilitate the development of sustainable and effective
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interventions to improve postdischarge outcomes in Uganda and other
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similar settings.'
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affiliation: 'Wiens, MO (Corresponding Author), BC Childrens Hosp, Ctr Int Child Hlth,
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Vancouver, BC, Canada.
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Wiens, MO (Corresponding Author), Mbarara Univ Sci \& Technol, Fac Med, Mbarara,
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Uganda.
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Nemetchek, Brooklyn; Owilli, Alex Olirus; Fowler-Kerry, Susan, Univ Saskatchewan,
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Coll Nursing, Saskatoon, SK, Canada.
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Khowaja, Asif, Univ British Columbia, Sch Populat \& Publ Hlth, Vancouver, BC, Canada.
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Kavuma, Anthony; Kabajaasi, Olive; Jacob, Shevin T.; Kenya-Mugisha, Nathan, Walimu,
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Mbarara, Uganda.
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Ansermino, J. Mark, Univ British Columbia, Dept Anesthesiol Pharmacol \& Therapeut,
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Vancouver, BC, Canada.
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Ansermino, J. Mark; Wiens, Matthew O., BC Childrens Hosp, Ctr Int Child Hlth, Vancouver,
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BC, Canada.
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Jacob, Shevin T., Univ Liverpool Liverpool Sch Trop Med, Dept Clin Serv, Liverpool,
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Merseyside, England.
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Kabakyenga, Jerome, Mbarara Univ Sci \& Technol, Maternal Newborn \& Child Hlth
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Inst, Mbarara, Uganda.
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Wiens, Matthew O., Mbarara Univ Sci \& Technol, Fac Med, Mbarara, Uganda.'
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article-number: e029526
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author: Nemetchek, Brooklyn and Khowaja, Asif and Kavuma, Anthony and Kabajaasi, Olive
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and Owilli, Alex Olirus and Ansermino, J. Mark and Fowler-Kerry, Susan and Jacob,
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Shevin T. and Kenya-Mugisha, Nathan and Kabakyenga, Jerome and Wiens, Matthew O.
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author-email: mowiens@outlook.com
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author_list:
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- family: Nemetchek
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given: Brooklyn
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- family: Khowaja
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given: Asif
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- family: Kavuma
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given: Anthony
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- family: Kabajaasi
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given: Olive
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- family: Owilli
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given: Alex Olirus
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- family: Ansermino
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given: J. Mark
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- family: Fowler-Kerry
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given: Susan
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- family: Jacob
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given: Shevin T.
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- family: Kenya-Mugisha
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given: Nathan
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- family: Kabakyenga
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given: Jerome
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- family: Wiens
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given: Matthew O.
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da: '2023-09-28'
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doi: 10.1136/bmjopen-2019-029526
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files: []
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issn: 2044-6055
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journal: BMJ OPEN
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keywords: Pediatrics; Patient Discharge; Qualitative Research; Uganda
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keywords-plus: CHILDREN
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language: English
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month: SEP
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number: '9'
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number-of-cited-references: '12'
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orcid-numbers: 'Kabakyenga, Jerome/0000-0003-1912-1032
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Kenya Mugisha, Nathan/0000-0002-2100-1833
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Derksen, Brooklyn/0000-0002-7842-3287
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Ansermino, J Mark/0000-0001-8427-2035
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Jacob, Shevin/0000-0003-2425-9394
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Wiens, Matthew/0000-0002-3287-5181'
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papis_id: cdc67653586410e98c60c2119761693d
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ref: Nemetchek2019exploringhealthcare
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researcherid-numbers: 'Jacob, Shevin/CAF-0449-2022
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Wiens, Matthew/J-9249-2019
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Kabakyenga, Jerome/IXN-6998-2023
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'
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times-cited: '4'
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title: 'Exploring healthcare providers'' perspectives of the paediatric discharge
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process in Uganda: a qualitative exploratory study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000497787600192
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usage-count-last-180-days: '1'
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usage-count-since-2013: '2'
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volume: '9'
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web-of-science-categories: Medicine, General \& Internal
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year: '2019'
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